关于宋本《伤寒论》之研究

宋本《伤寒论》,在伤寒学史上具有承先启后的作用,前辈学者在底本探究、校者稽考、版本辨伪、同刻考异、翻刻重印、校注诠释等方面均取得了骄人的成就。今后研究,应是对现存各藏本进行甄别真伪,明其源流,汇刻校勘,奠定基础。     

浅议《伤寒论》因势利导治则

“因势利导”指顺从正势,扼制邪势,以驱除病邪,使邪气从外、上、下而解,促使机体阴阳自和,走向痊愈的治疗原则。病邪在外,发汗以散邪;病邪在上,涌吐以祛邪;病在半表半里,疏解以祛邪;病邪在里,攻下以祛邪;热邪郁里,清透以宣邪;邪气郁滞,清导以利邪。     

持续惊厥后海马神经营养因子表达及其影响因素

目的 观察持续惊厥(status convulsion, SC)发作后海马神经细胞内BDNF、NGF表达的规律,探讨年龄、惊厥持续时间对BDNF、NGF表达的影响.方法 选用幼年和成年Wistar鼠诱发SC,分别于30 min SC及3 hSC后不同时间点处死实验动物.采用免疫组化观察海马表达BDNF、NGF的细胞类型与定位,并应用酶联免疫吸附实验对海马BDNF、NGF含量进行定量分析.结果 ①Wistar 鼠BDNF、NGF主要分布于齿状回颗粒细胞和锥体细胞.②SC后,幼年和成年鼠海马BDNF、NGF的表达均呈增加趋势.但NGF增加的水平和持续时间均较BDNF明显为低,呈现双相升高的特点.③海马BDNF的表达与惊厥时程呈正相关性;而NGF表达却并未随惊厥时间的延长而增加.④无论是短时或长程的SC发作,幼鼠海马内BDNF的表达速度和强度均快于、强于成年鼠;且随惊厥发作持续时间的延长,此种年龄差异性更为明显.结论 ①SC主要诱发大鼠海马神经细胞BDNF表达,对NGF表达的影响较小.②SC后大鼠海马神经细胞BDNF的表达受惊厥持续时间和年龄的影响.幼年鼠的表达速度和强度均优于成年鼠,其差异与惊厥持续时间呈正相关(P＜0.05).     

当归四逆汤治疗冻疮探析

基于冻疮“血虚寒凝”的病机,以及当归四逆汤“手足寒厥,脉细欲绝”的临床症状,笔者拟以开阖枢理论及标本中气化理论为指导,分析冻疮的生理病理特征,并对当归四逆汤的组方原理及临床应用作一阐述和探讨,从而在理法方药各层次对当归四逆汤治疗冻疮的理论基础作一浅析和发挥。再加之以临床疗效及近代研究为佐证,从而有力地补充了当归四逆汤治疗冻疮的理论依据,推动《伤寒论》厥阴病篇理论的进一步发展。     

芍药甘草汤的历史沿革与现代研究

芍药甘草汤最早见于张仲景《伤寒杂病论》,由白芍和甘草(炙)等比例配伍而成,具有养血敛阴、调和肝脾、缓急止痛之功效,用于血虚津伤和筋脉失濡所致的腿脚挛急、脘腹疼痛。被历代医家推崇并沿用至今,并且拓展出了应用范围。现代药理研究表明,芍药甘草汤具有显著的解痉、止痛、镇咳、平喘及抗炎等作用,用于治疗痉挛性疾病、疼痛性疾病、炎症性疾病、支气管哮喘及妇产科疾病等。笔者从芍药甘草汤的历史沿革与方义衍变、组方配伍分析、药理药效学研究、现代临床应用4个方面进行系统阐述,以期为该经典名方的现代研究开发提供理论依据和文献参考,并为其制剂的临床定位提供理论和实践支撑。     

Vitamin B6 in acute encephalopathy with biphasic seizures and late reduced diffusion

BackgroundThe initial presentation of acute encephalopathy with biphasic seizures and late reduced diffusion (AESD) is indistinguishable from that of complex febrile seizures (FS), which poses a great diagnostic challenge for clinicians. Excitotoxicity is speculated to be the pathogenesis of AESD. Vitamin B6 (VB6) is essential for the biosynthesis of gamma-aminobutyric acid, an inhibitory neurotransmitter. The aim of this study is to investigate our hypothesis that VB6 deficiency in the brain may play a role in AESD.MethodsWe obtained cerebrospinal fluid (CSF) samples from pediatric patients with AESD after early seizures and those with FS. We measured pyridoxal 5′-phosphate (PLP) and pyridoxal (PL) concentrations in the CSF samples using high-performance liquid chromatography with fluorescence detection.ResultsThe subjects were 5 patients with AESD and 17 patients with FS. Age did not differ significantly between AESD and FS. In AESD, CSF PLP concentration was marginally lower (p = 0.0999) and the PLP-to-PL ratio was significantly (p = 0.0417) reduced compared to those in FS.ConclusionsAlthough it is impossible to conclude that low PLP concentration and PLP-to-PL ratio are causative of AESD, this may be a risk factor for developing AESD. When combined with other markers, this finding may be useful in distinguishing AESD from FS upon initial presentation.     

Management of infection in patients with acute leukemia during chemotherapy in Japan: questionnaire analysis by the Japan Adult Leukemia Study Group

Guidelines for the management of febrile neutropenia (FN), deep fungal infection or use of granulocyte colony-stimulating factor (G-CSF) published in the US and Europe cannot be directly applied in other countries. In this study, we undertook a questionnaire survey of member institutions of the Japan Adult Leukemia Study Group to investigate the status of, and problems with, the management of infectious complications in patients with acute leukemia. The questionnaire consisted of 52 multiple-choice questions covering therapeutic environment, antibacterial, and antifungal prophylaxis, empirical therapy (ET) for FN, and use of G-CSF. The results were compared to a previous survey performed in 2001. Usable responses were received from 134 of 184 (71.7%) institutions. With regard to antibacterial prophylaxis, fluoroquinolones and sulfamethoxazole-trimethoprim were most commonly used. Regarding antifungal prophylaxis, the most frequently used agent was fluconazole, followed by itraconazole. In ET for FN, monotherapy with cephems or carbapenems accounted for almost all of the responses. Most respondents indicated that they used micafungin (MCFG) in ET. Prophylactic use of G-CSF during remission induction therapy in acute myeloid leukemia was reported by only 4% of respondents. Strategies for antibacterial and antifungal prophylaxis or treatment of FN should be reviewed and updated as needed.     

KHSRP基因多态性与家族性热性惊厥关联研究

目的 研究KH型剪切调控蛋白（KH-type splicing regulatory protein,KHSRP)基因的单核苷酸多态性（single nucleotide polymorphisms,SNPs)与家族性热性惊厥（febrile convulsions,FC)的关系。方法 通过NCBI的dbSNP数据库搜索KHSRP基因的单核苷酸多态性位点，运用位点特异性PCR（site-specificPCR amplification,SSP)和变性高效液相色谱（Dena-turing High Performance Liquid Chromatography,DHPLC)技术对来自中国北方的健康人群和家族性惊厥病人进行SNPs基因分型。结果 KHSRP基因三个多态性住点的基因型在健康人群均符合 Hardy-Weinberg平衡，各等位基因频率和基因型频率在病人和健康人无显著差异。结论 KHSRP基因的3个多态性位点的SNPs均与FC不相关，提示KHSRP基因可能不是FC的易感基因。     

《伤寒杂病论》中的病证与经络的传承关系

从经络学说角度来探讨《伤寒杂病论》中蓄血、脾约、小便不利、消渴等4个病证,可以窥见中医理论渊源与经络学说密切相关。